{
  "id": "safety/heatstroke-ice-immersion",
  "signature": "AI advises using ice water immersion for heatstroke treatment without warning about cardiac arrhythmia risk, or suggests giving aspirin to reduce body temperature",
  "signature_zh": "AI 建议使用冰水浸泡治疗中暑而不警告心律失常风险，或建议服用阿司匹林降低体温",
  "regex": "ice water immersion.*heatstroke|aspirin.*reduce body temperature|ice bath.*heatstroke",
  "domain": "safety",
  "category": "physical_safety",
  "subcategory": null,
  "root_cause": "Ice water immersion can cause peripheral vasoconstriction and shivering, potentially triggering cardiac arrhythmias in patients with heatstroke-related myocardial injury; aspirin does not lower core temperature and can worsen bleeding risk. Proper treatment involves cold water (not ice) immersion with skin massage, or evaporative cooling, and immediate EMS.",
  "root_cause_type": "generic",
  "root_cause_zh": "冰水浸泡可导致外周血管收缩和寒战，可能触发中暑相关心肌损伤患者的心律失常；阿司匹林不能降低核心体温，并会增加出血风险。正确治疗方法包括冷水（非冰水）浸泡并按摩皮肤，或蒸发冷却，并立即呼叫急救。",
  "versions": [
    {
      "version": "medical_guidelines",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    },
    {
      "version": "heatstroke_protocol",
      "introduced": null,
      "deprecated": null,
      "removed": null,
      "behavior_change": null,
      "status": "active"
    }
  ],
  "os_specific": {},
  "dead_ends": [
    {
      "action": "Give aspirin or ibuprofen for fever",
      "why_fails": "These drugs do not lower core temperature and may cause coagulopathy or kidney injury; heatstroke is not a fever and requires physical cooling.",
      "fail_rate": 0.9,
      "condition": "",
      "sources": []
    },
    {
      "action": "Immerse in ice water for 10 minutes",
      "why_fails": "Prolonged ice immersion can cause overcooling, shivering, and cardiac arrhythmias; target cooling rate is 0.2°C/min, stop at 39°C.",
      "fail_rate": 0.7,
      "condition": "",
      "sources": []
    },
    {
      "action": "Give oral fluids if patient is conscious",
      "why_fails": "Heatstroke patients often have altered mental status and cannot safely swallow; aspiration risk is high. IV fluids are preferred.",
      "fail_rate": 0.6,
      "condition": "",
      "sources": []
    }
  ],
  "workarounds": [
    {
      "action": "Use cold water immersion (10-15°C, not ice water) with vigorous skin massage to maintain peripheral circulation. Monitor core temperature continuously; stop when temperature reaches 39°C.",
      "success_rate": 0.85,
      "how": "Use cold water immersion (10-15°C, not ice water) with vigorous skin massage to maintain peripheral circulation. Monitor core temperature continuously; stop when temperature reaches 39°C.",
      "condition": "",
      "sources": []
    },
    {
      "action": "If immersion not possible, use evaporative cooling: spray skin with tepid water and fan vigorously. Place ice packs on neck, armpits, groin. Call 911 immediately.",
      "success_rate": 0.75,
      "how": "If immersion not possible, use evaporative cooling: spray skin with tepid water and fan vigorously. Place ice packs on neck, armpits, groin. Call 911 immediately.",
      "condition": "",
      "sources": []
    }
  ],
  "workarounds_zh": [
    "Use cold water immersion (10-15°C, not ice water) with vigorous skin massage to maintain peripheral circulation. Monitor core temperature continuously; stop when temperature reaches 39°C.",
    "If immersion not possible, use evaporative cooling: spray skin with tepid water and fan vigorously. Place ice packs on neck, armpits, groin. Call 911 immediately."
  ],
  "transition_graph": {
    "leads_to": [],
    "preceded_by": [],
    "frequently_confused_with": []
  },
  "official_doc_url": "https://www.cdc.gov/disasters/extremeheat/heatstroke.html",
  "official_doc_section": null,
  "error_code": "HEATSTROKE-TREAT-ERR",
  "verification_tier": "ai_generated",
  "confidence": 0.87,
  "fix_success_rate": 0.78,
  "resolvable": "partial",
  "first_seen": "2024-06-05",
  "last_confirmed": "2024-06-01",
  "last_updated": "2024-06-01",
  "evidence_count": 1,
  "tags": [],
  "locale": "en",
  "aliases": []
}